Does anyone know of a reliable method to screen new clients for Body Dysmorphic Disorder?
You mean, before they are standing in your office with no visible hairs at a conversational distance, and tell you they are a bear, and need 20 hours of face work on their normal vellus hairs?
Not likely.
Yes James. People with Body Dysmorphic Disorder are emotionally disturbed and no amount of hair removal will help them. They will always find additional hair and flaws and on rare occasions will blame the electrologist for them. Like Mike Bono, I believe there are situations where it is prudent to not treat. Up to this point I have been using obvious clues, signs, symptoms, etc., however I would prefer a standardized screening questionnaire based on scientific studies. As electrologists, we sometimes see “invisible” hair cases that live with a 10X mirror, convinced their life has been destroyed because they have a beard! Sometimes the individual is better served by psychiatry, not electrology.
As one family of a BDD client said to their practitioner; “electrolysis costs less than therapy, the client talks to the practitioner, and is actually willing to keep the appointments.” Their family member eventually came out of it, and now admits that perhaps more work than needed was requested by the client.
I think one problem we face is that while these people most likely resist the idea of BDD, they can sometimes benefit from the normal nagging electrolysis practitioners often give them. The nutrition, and check on what normal people find to be noticeable, and even the advice to throw away the 10x’s magnification mirror.
Clients with BDD are very difficult if not impossible to satisfy. Many have unrealistic expectations in spite of being told otherwise and nothing is good enough or fast enough to please them! It is an uphill battle given their obsession with unwanted hair is only a symptom of an underlying psychological condition that electrology, as a rule cannot resolve. A typical group of symptoms might include the client that marks or counts tiny hairs in a 10X magnifying mirror and demands the electrologist only treat and remove the marked hairs. These clients have an emotional attachment to specific hairs and will let you know which ones were “missed” during a treatment. Some want to point to “bad” hairs and watch while you remove them in requested sequence (this drives me crazy). I have a lady that brings a flashlight with her and is convinced it helps me see better than a surgical spotlight! It is important to have a standard by which to screen new clients to determine if they have BDD. In cases where an individual shows significant signs of BDD, it would be my decision to not treat.
And you are certainly within your rights to refuse to do business with such a person.
I recall a client protest in Atlanta where black men were going in to electrolysis offices and staging sit-ins, because so many had been refused treatments. The practitioners were most often refusing to take on a treatment job that they felt unprepared to do a good job, and for which they had little or no experience, and were afraid would lead to law suits for keloids. All the black men saw was racism in the heart of the old Confederate States of America.
While I have obvious sympathy for the men who staged this protest, I have to also show sympathy for the practitioners.
In the end, some people will take these customers, as they can be a steady source of business, and others will pass on this business due to the negatives involved in the undertaking.
Certainly the keloid issue as it relates to treatment of black skin has been over hyped. In my 32 years in practice I have never observed a keloid from electrolysis and have always experienced great satisfaction in treating black clients, especially those with severe cases of folliculitis. The change in skin condition is so dramatic it can alter a person’s life.
I have never seen a keloid as a result of electrolysis, and spent many years campaigning to get practitioners to work on dark skinned people. I had a bad keloid problem that lasted from my late teens through my late 20’s, and with all the long hours of electrolysis I have had from practitioners and students, good and bad, I NEVER got an electrolysis related keloid, even when I was suffering from the worst manifestations I ever had from that condition.
For men who actually have keloids, or just thick wiry ingrown hairs, electrolysis is actually the thing which resolves their skin condition, allows the color to return to normal, and the constant state of inflammation that becomes their everyday living hell to end.